Still No Drop in the CDDS Data
posted by Interverbal at 11:24 PM
Wednesday, January 10, 2007
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13 Comments:
Hmm....
Trend is still increasing, isn't it?!
Somebody's not going to be happy....
nice work. it's pretty clear to the casual observer, who doesn't have a finanical agenda.
Stupid question time: Do the spikes correspond to uptakes in the fall?
As I recall most public schools provide only limited services during the summer, so many kids whose birthdays fall in the summer need to wait until fall.
PLUS... many kids in the 5 to 6 year old age group are only brought into the database if the school identifies them. In conversations with speech and OT/PT therapists at my son's school they often found kids who needed services as they entered kindergarten. Often time the parents had no idea that their child was behind in some areas, or were reluctant to even try to get their child evaluated.
The latter I have personal experience with... There was a boy in my daughter's preschool whose language development was obviously delayed. Since I had a child with speech problems, I shared with the family all the resources I had for free or reduced fee speech and language services that were available (at least four local agencies, all within 3 miles of the preschool!). They did absolutely nothing. I learned later from the preschool teacher that the child started to finally receive speech/language therapy after he entered kindergarten and was identified during the school district's standard evaluations.
The numbers do not come from school system data, they come from the California-state Regional Centers. Therefore, having nothing to do with a school calendar.
That is a good question and one a few of us have looked at before.
The most common spikes occur in March. There are all sorts of reasons this might happen, or it could just be a statistical fluke.
My best guess is that the parents come into school with new students gain better access to information about services and apply for other formal diagnostics and it just takes until the next quarter before they get processed.
On notable spike occurred in July 2003, this might be accounted for the CDDS diagnosticians and personnel hustling to get people into the system as they were aware of the CDDS autism criteria being reviewed in the California legislature.
Also, does the change in criteria, making it much tougher for those with ASD to receive services, make it even more difficult to assess the true increase?
I'm thinking of those (dx. ASD) who rec'd services prior to the criteria change (was it in '03?) who would now certainly be excluded were they in the 3-5 age range today. (This could well have changed our family's situation).
Sidenote: From personal experience, so many schools here in California are on a year-round calendar or ESY (extended school year) that there's really no substantial summer break.
Yes, that would be expected. Arguably the legislature implemented the new restrictive criteria, to only offer CDDS services to the persons on the more severe end of Autistic Disorder.
This would:
A) Further erode the validity of using the CDDS as a measure of autism in California
B) Mean that CDDS diagnosticians might be more likely to fudge diagnostics, to help families get services.
Late July 2003, was the revision to the Lanterman Act.
Point noted re: the California school year.
Thanks, Jonathan, for you reply. I had been going back-and-forth with your (B) in my head as well, trying to determine which I thought was most likely. I know that some RCs are known for being easy givers of the Dx. and others impossible, unless, it could be deemed "severe" (their term).
Also, to HCN, too. Please know I wasn't trying to argue the school thing, it's just that there's so many variables with the RCs and no givens that I have been perplexed that the data was ever referred to as "The Gold Standard". Having been a client (on and off) for 7 years, I have to say there seems to rhyme or reason to some of the things I've seen. I will say, however, that in the month of August nothing happens so that could always have some kind of factor in that quarter.
Bottom-line: One can't make any hard-and-fast rules about that data, as has been said it's "administrative" and that makes it clearer -- it has much more meaning for the RCs internally.
Jonathan, I agree with your (A) that it does further erode the validity of using this data for Calif ASD measures. I really wonder how we could get any kind of estimate on those who have an AS or PDD dx and are not able to become clients of the RC.
A friend from Cali
Interverbal said "The most common spikes occur in March. There are all sorts of reasons this might happen, or it could just be a statistical fluke."
Actually that makes sense to me. After my son was accepted to special ed. preschool in October (Septemeber birthday), I learned from other parents about a free resource for speech therapy from another parent.
That would also include finding out about state services like the Dept. of Developmental Disabilities and the Federal servies like Social Security Insurance... None of which we qualified because of income level. But now that son is 18 we've been told to get him in both databases for help in supportive employment after he graduates from high school.
Thanks for the explanations!
Anon said "The numbers do not come from school system data, they come from the California-state Regional Centers. Therefore, having nothing to do with a school calendar. "
Thanks for the clarification... I don't live in California, so I'm clueless.
We've either received services through the school district or through a private charity (Scottish Rite) since we never qualified through the state due to income. We have also had some speech therapy payment through private insurance and have also paid for speech and other therapies with our own money (the last highly recommended psychologist was dropped from the insurance referral list just before our son went to see him).
So I can see why the CDDS data would not be all encompassing.
Thanks for that, HCN. In California, income didn't matter for services. Then shortly before they announced they were changing the criteria, they began to ask for some real specifics: tax returns and additional income information. They then began to ask certain clients to submit to a "financial audit". I know many who dropped out then. Many. That's why that one spike that's referred to (the big upward one in July 2003) perplexes me even more, because at the same time the RCs were probably hustling to get clients in prior to the criteria change, another large chunck were dropping out due to not wanting to be audited. So, on it goes, with more and more confusing variables (at least to me).
Friend in Cali
It's clear Kirby ain't the only one that can't read data. The 3-5 age group is useless data because it's a moving target. It's obvious that many diagnosis are not made (or reported) prior to the age of 3.
As I explained on Autism Street, you really need to look at the 6-9 age group if you want some data with some consistency behind it.
There is too much undercounting in the 3-5 age group for it to be valid measuring base. Any increase could simply be the result of more accurate counting. There does not appear to be the same level of undercounting in the 6-9 age group.
“It's clear Kirby ain't the only one that can't read data.”
Is it?
“The 3-5 age group is useless data because it's a moving target. It's obvious that many diagnosis are not made (or reported) prior to the age of 3.”
True, although in the sense of growth and undercounting, the 6-9 is also problematic.
“As I explained on Autism Street, you really need to look at the 6-9 age group if you want some data with some consistency behind it.”
I paid attention, but as I also explained, the growth doesn’t stop at age 9. The only advantage the 6-9 group has over the 3-5, is that the 6-9 group will do less growth in four years.
Also, if we are talking about consistency, then we shouldn’t ignore the fact that the 3-5 data consistently predicts a certain amount of growth in the 6-9 category.
”There is too much undercounting in the 3-5 age group for it to be valid measuring base.”
But…. We have a good idea how much we undercounted by.
“Any increase could simply be the result of more accurate counting. There does not appear to be the same level of undercounting in the 6-9 age group.”
You are correct, but even so, I would argue that a 30% growth is still significant when we are talking about several thousand children.
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